Medical oncology
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Randomized Controlled Trial
The palliative treatment with intrapleural streptokinase in patients with multiloculated malignant pleural effusion: a double-blind, placebo-controlled, randomized study.
Expansion of the lung is necessary for successful pleurodesis therapy in patients with malignant pleural effusion (MPE). However, this is often impossible in multiloculated MPEs. The aim of this study was to investigate the effect of the fibrinolytic agent, streptokinase, on pleurodesis therapy used in the management of multiloculated MPE. ⋯ The dyspnea symptoms disappeared in 90 % of the patients in the fibrinolytic group and in 55 % of the patients in the control group (P = 0.03). Recurrence rate was 11 % in fibrinolytic group and 45 % in control group (P = 0.07). Streptokinase is a reliable treatment option in obtaining effective pleural drainage and increasing lung expansion in patients with multiloculated MPE.
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Platelets play an important role in metastasis of circulating tumor cells (CTCs). It has been demonstrated that hydroxyethyl starch (HES) inhibits platelets function. However, the effect of HES on CTCs in patients with colorectal cancer remains unclear. ⋯ In summary, we found that HES 200/0.5 significantly decreased CTCs of patients undergoing colorectal cancer radical surgery as compared to HES 130/0.4, which might be associated with inhibiting platelets activation of HES 200/0.5. Furthermore, HES 200/0.5, but not HES 130/0.4, reduced the metastatic potential of colon cell line stimulated by activated platelets through depressing platelets activation. Modulation of platelets activity may be a novel strategy to minimize the risk of metastasis during surgery.
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Randomized Controlled Trial Multicenter Study
An open-label, randomized, multicenter dose-finding study of once-per-cycle pegfilgrastim versus daily filgrastim in Chinese breast cancer patients receiving TAC chemotherapy.
A chemotherapy regimen of docetaxel, doxorubicin and cyclophosphamide (TAC) has been accepted as a standard care because of their superior clinical benefit in early-stage breast cancer patients, but with a higher risk of neutropenia. Pegfilgrastim is a once-per-cycle therapy for prophylactic neutrophil support and neutropenia prevention. There was still a lack of direct evidences for finding an optimal fixed dose of pegfilgrastim in Chinese breast cancer patients receiving TAC regimen. ⋯ The results for febrile neutropenia, time to neutrophil recovery and neutrophil profile were also not significantly different between arms. The safety profiles of pegfilgrastim and filgrastim were similar. A single dose of 100 µg/kg once-per-cycle administration of pegfilgrastim provided neutrophil support and a safety profile comparable to daily subcutaneous injections of filgrastim in Chinese breast cancer patients receiving TAC chemotherapy.
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Recent studies demonstrated that second-line chemotherapy of continuous usage of bevacizumab after initial disease progression improved survivals in Caucasian patients with metastatic colorectal cancer (mCRC). We intended to examine this strategy in Chinese patients specifically. Eligible Chinese mCRC patients had disease progression up to 3 months after receiving first-line bevacizumab-included chemotherapy. ⋯ No patients had complete responses, but 17 patients had partial response and 75 had stable disease. The safety profiles showed that severe adverse events (grades 3-4), such as nausea, proteinuria and hypertension, were often experienced by Chinese mCRC patients received continuous second-line chemotherapy of bevacizumab. Continuous usage of bevacizumab as second-line chemotherapy for patients with metastatic colorectal cancer in China showed equivalent improvement on patients' survival as Caucasian counterparts.
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Review Meta Analysis
Cetuximab in patients with esophageal cancer: a systematic review and meta-analysis of randomized controlled trials.
Esophageal cancer is one cause of the most common cancer death and diagnosed in approximately half a million people annually worldwide, as well as has resulted in worse status, which is responsible for an estimated 482,300 new cases and 406,800 deaths in 2008, and is the fifth highest in the mortality rate among tumor sites. Esophageal cancer mainly occurred in southern and eastern Africa, eastern Asia and some areas of China. ⋯ Moreover, collated differences in overall survival rate and progression-free survival remained the most common grade 3/4/5 toxicities, and quality of life after intervention revealed no evidence of a difference between the two groups. With the present evidence, there is no role for cetuximab combined with standard approaches for esophageal cancer.